Team:NJMU-China/Social Medicine Reasearch
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Overview
As stated before, we have noticed that what hinders autism early detection is not only the lack of reliable diagnostic methods but numerous social-psychological factors behind. Figuring out these social-psychological factors allows us to better work out strategies and policies to improve the early diagnosis rate of autism, bringing early behavioral intervention into effect, and ultimately reducing families’ financial burden and the socioeconomic and public health burden.
What’s Social Medicine?
Social Medicine is a specialized field of medical knowledge concentrating on the social, cultural, and economic impact of medical phenomena1. The discipline of social medicine applies social sciences and humanities to shed light on the economic and sociopolitical forces that shape the health of individuals and communities, the experience of illness, the culture of medicine, and the delivery of health care2. Social medicine enables us to address critical challenges by recognizing common patterns across patients, ones that reflect something more fundamental about our society and the health of our health care system itself3. Here is a case study based on social medicine: an 18-month-old boy in La Soledad, Mexico, presents with pneumonia, to which he was predisposed by malnutrition. When nutrition education and food-production efforts fail, a physician and a community collaborative work to elucidate the deeper roots of the problem4.
In order to learn about the factors behind, we conduct qualitative research that aims to develop concepts that aid in the understanding of natural phenomena with emphasis on the meaning, experiences and views of the participants5.
How we did Social Medicine?
Firstly, we made preliminary preparations. After the literature review, we have carefully designed the outline of the face-to-face interview and conducted standardized training for controlling the errors caused by different interviewers. We also obtained informed consent before the interview.
With structured or semi-structured interviews, we would be able to investigate the whole process from suspecting children of autistic symptoms to deciding to seek professional medical help. We conducted interviews with two autistic child’s parents at Haizhixing Autism Children Rehabilitation Center. We did a summary about the interview and conclusions are as follows: insufficient understanding of the early symptoms of autism (educational factors), the cost of nursing and special education are too high (economic factors), and the family is ashamed to speak out and the pressure of family ugliness (cultural factors). The family's increased acceptance of children, the society's provision of continuous and effective support resources, and the promotion of a family-centered educational community are important bases and safeguards for the social support system.
After this initial investigation, we have a preliminary understanding of the factors behind, and the outline and question design of the interview are being further optimized. We plan to conduct a more systematic and in-depth study in November.
References
1. Silver, G. A. Social Medicine and Social Policy. YALE J. Biol. Med. 57, 851–864 (1984).
2. School, D. of G. H. and S. M. H. M. About us. http://ghsm.hms.harvard.edu/about-us (2014).
3. https://monthlyreview.org/2005/01/01/what-is-social-medicine/.
4. H. Carrasco, L. Messac, and S. M. H. Misrecognition and Critical Consciousness. N. Engl. J. Med. 380,
2385–2389 (2019).
5. Al-busaidi, Z. Q. Qualitative Research and its Uses in Health Care. 8, 11–19 (2008).